Thank you Martha S. for providing your experiences and recommendations for other caregivers.
“My husband was independent for several years following a serious stroke in late 2002 and his eventual recovery. In April 2007 paramedics rushed him to the emergency room with severe leg pain. I worked part time then and met him at the hospital.
All tests checked out fine, he was alert, and could get up just fine. However, the emergency room doctor wanted to monitor his blood pressure. He was placed on a low dose of nitroglycerin and an automatic blood pressure machine. In the night, a nurse turned off the pump. I reported to the ER doctor that the pump was off and his blood pressure was going up. The doctor said they were watching it but no one came in to turn the pump back on. His pressure continued to go up higher.
A few hours later, another doctor sent my husband to ICU. My family became very upset, knowing that if he had to be in bed for several days he would lose his strength and independence. He was placed on two new meds and moved to a progressive care room. He was sleepy, non-responsive, and wouldn’t cooperate which was not like him. We believed he was over-medicated.
I was still working part-time when my husband was transferred from ICU to a progressive care room. That’s when he really went downhill on two new meds. He was alone much of the time, over-medicated, and had a rough week. The doctor even apologized for keeping him a day or two extra because he had to put him back on Coumadin, a blood thinner.
After two weeks in the hospital, including some physical therapy, he was discharged. He could barely walk and came home much worse than when he went in.
After a day at home he had to go to a rehab facility where medications were changed again before his release after 20 days. Because we had not used his power chair since his 2002 stroke, it required a battery which had to be requested through home health. The home health agency is the best we have had. Until he could use his power chair, my husband sat in his lift chair, and lived there, for several days.
We survived this together. We had a lot of new experiences. He needed much assistance during the summer. For a while he had to use adult diapers which was a new experience for him. He finally started wearing regular clothing.
He takes care of himself now. When he wakes up in his lift chair in the den, where he sleeps, he places his brace/shoes on. When he could walk into the shower that was a big day for us! He now has to sit in his power chair to get dressed. But he walks out of the master bath to kitchen for the exercise. Then he sits down in the power chair for breakfast.
By September 2007, he had made another good recovery. He could walk to a car with a walker to go to church or soccer games, or Amon Carter Museum. He will always need the power chair.
I learned so much during our first emergency room and hospital stay a year ago. When my husband had to go back to the hospital this year I knew more what to do. I had such negative feelings from the year before, I didn’t want to sit around and be stressed. This time the night-time ER nurse was outstanding. We reviewed meds. One was recorded incorrectly. She believed me so my faith was restored to some degree in the hospital organization.
My husband has made so much cognitive improvement. His brain continued to heal and “re-wire.” I’m thankful to have been able to resign my part time job to be at home. It’s allowed all our family to be together.
Points I have learned:
- Always send a printed list of medications, if paramedics take a loved one to an emergency room and you are not with the patient. Carry a copy with you at all times.
- Be careful that the ER staff correctly writes down the patient’s medications when they go over this.
- When a patient in ER is on a pump for blood pressure and it shows that the blood pressure is rising, go find the doctor. If he says they are watching it, and no one comes to the room, immediately find the doctor, and insist that someone come to the room.
- My husband feels strongly about not having a catheter so make sure this preference is written down, in big letters, and sent with the paramedics. Be certain paramedics understand this. A doctor may override that decision but at least a preference is known.
Editor’s Note: A Medical Power of Attorney where specific wishes of a patient are stated is the best option.
ICU (Intensive Care Unit)
- When a patient is transferred to ICU, and the nurse reviews medications, be certain to mention all of them or give them a copy of your list. Do not assume that they will administer every medication that is on the list, especially if it has not been discussed. If they don’t administer what the person usually takes, ask for clarification about what is being administered.
- The nurse only mentioned blood pressure meds. I didn’t mention Lexapro. I assumed it would be started. It is for emotions. It wasn’t administered for several days. I should have asked. We were all so concerned about him being in a bed, and not walking, while in ICU. Evidently some Lexapro was still in his system for a while.
- Always keep a notebook, write down everything and include dates and times.
- Be very open and positive with hospital staff.
I hope this information helps someone else. Mainly, I now think that when there is a strong sense of whether to do something, or not, we should act accordingly.
Edited by Zanda Hilger.